Skip to main contentLast updated: 24-Oct-2026
Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Gastro & Cancer Surgeon
Apollo Hospital, Bhat, Gandhinagar · Gota OPD, Ahmedabad · 18 years of experience
★★★★★ Google: 4.89 from 216 reviews (Gota clinic) · 4.94 from 18 reviews (Apollo, Bhat)
In short
An endoscopic procedure on the pylorus is a later step. It is considered only after food changes and a fair medicine trial have not worked.
The idea is simple. In some people the stomach outlet stays tight and food cannot leave. Cutting the muscle of that outlet lets food pass.
Choosing the right person decides the result. A person with a tight outlet may gain a lot. A person without it may gain nothing.
All the treatment options, including surgery on the pylorus, are on the gastroparesis treatment in Ahmedabad page. This post explains the procedures done through the mouth.
A procedure comes after the basics. Food changes and a fair medicine trial must come first, and any slowing drug must be cleared.
Treating a drug effect with a cut that cannot be undone would be a clear mistake. That is why these steps are never skipped.
The pylorus is the valve at the stomach exit. In some people it stays tight, and food waits behind it.
Botulinum toxin relaxes the pylorus for a few months. Careful trials found that it does not ease symptoms better than a dummy injection.
It is still given often in India. If it is offered to you as treatment, ask why.
No single symptom shows a tight pylorus. A measurement of how well the valve stretches comes closest.
| Test | What it tells you | Limit |
|---|---|---|
| Stretch measurement of the pylorus (EndoFLIP) | How stiff the valve is | Not available in every centre |
| Gastric emptying scan | Confirms the stomach is slow | Does not show where the problem lies |
| Pressure study of the stomach and bowel | How the muscle is working | Invasive; used in few centres |
| Response to a temporary opening | Whether symptoms ease | Not fully proven; the effect is brief |
A stiff valve on the stretch test points to a better result. Where the test is not available, the doctor relies on the full picture. This includes retained food and the emptying scan.
G-POEM stands for gastric per-oral endoscopic myotomy. The pyloric muscle is cut from inside the stomach, with no cut on the skin.
Most people stay in hospital for a day or two. Drinks start first, then soft food. A trained team that does this often matters a great deal.
A trial with a dummy procedure showed that G-POEM helps more than placebo in severe cases. The benefit is real, but it can fade over time.
No operation can promise a result. An honest talk about these limits comes before consent.
G-POEM is safe in experienced hands. The most common disappointment is no benefit, not a serious complication.
Both open the valve. The choice depends on whether anything else must be done at the same time.
These operations are set out on the gastroparesis treatment page.
If G-POEM does not help, repeating it is not the first move. The cause is looked for again.
Follow-up is covered in the post on gastroparesis complications and follow-up.
After food changes and a fair medicine trial have not worked, and slowing drugs are cleared.
The pyloric muscle is cut from inside the stomach through the mouth. There is no cut on the skin.
No. Trials show no real gain in symptoms. It is at most a short test.
A stretch test of the pylorus, an emptying scan and the full picture are used together.
No. Some people gain a lot, some gain for a while, and some gain nothing.
The cause is looked at again. A repeat G-POEM, surgery or another plan may follow.
The full range of procedures is on the gastroparesis treatment page. For questions before you travel, call +91-63555-64601.
Shah’s Gastro, Cancer & Robotic Surgery Centre, Gota, Ahmedabad
Consultation, review of endoscopy, emptying test and scan reports, second opinions and follow-up.
Apollo Hospital, Bhat, Gandhinagar
Apollo Hospital International Limited, GIDC Bhat Industrial Estate, Bhat, Gandhinagar. Endoscopy and biopsy, CT scans, stomach emptying tests, endoscopy, surgery for stomach disorders, and inpatient care.
Food and tablets have not settled a slow stomach? The tight outlet of the stomach, the pylorus, may be part of the problem. A procedure through the mouth can open it, but only for the right person. Send your reports ahead on WhatsApp so they are read before you come. Whether this suits you is decided at the consultation, after examination. Call +91-63555-64601 Send your reports before the visit
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